Healthcare Uncovered Episode 13: CHIRA: Leveling the Playing Field for Doctors

Doctors – how much do you know about CHIRA – the Competitive Health Insurance Act passed in 2020 during the height of the pandemic? It’s a real game changer for doctors. This week on Healthcare Uncovered I'm going to make sure you know how CHIRA will impact YOUR practice.

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Did you know that up until 2020, health insurance companies were exempt from federal antitrust laws? It’s kind of crazy right? For 70 years, the laws that prevent businesses from colluding and engaging in anti-competitive activity didn’t apply to health insurance companies.

How was that possible?  

The McCarran-Ferguson Act

Back in 1945, Congress and President FDR were swayed by state insurance regulators to pass what was called the McCarran-Ferguson Act, which made insurance regulated by the states and not the Federal Government, essentially exempting insurance companies from Federal Anti-trust laws.

As you can imagine, doctors, hospitals, employers, and patients repeatedly tried to have the McCarran-Ferguson Act repealed. The last major push to repeal the law came in 2017 and failed. Big Healthcare Insurance lobbyists always succeeded in pushing off attempts to repeal this sweetheart of a deal they had.  

But then Covid hit.

The Competitive Health Insurance Act

In 2020 -- during the height of the COVID pandemic -- Congress passed and the President signed the Competitive Health Insurance Act also known as CHIRA which ended most of the health insurance exemptions from Federal Anti-trust regulations.

After the passage of CHIRA the US Justice Department issued a press release indicating it was interested in taking advantage of these new anti-trust enforcement powers that it now wielded.  

The National Law review published an article stating that CHIRA would open the door for private litigation against health insurance companies for anti-competitive behavior as well.

Now what does this all mean for doctors?  

1. It levels the playing field. Physician practices have always been subject to anti-trust law and now health insurance companies are as well.  
2. A physician practice can now consider suing a health insurance company in civil court for damages caused by the anti-competitive behavior of a health insurance company.

Doctors, you do have rights. You can push back and you can seek alternatives to the traditional health insurance payers. It’s time to get more vocal about what’s happening to you and your practice.  

Healthcare shouldn’t be complicated. Check out Nomi Health’s Open Network of physicians to break through the red tape, collect the money you’ve earned, and get back to why you’re doing this in the first place.... helping patients.